Capsular Contracture Repair with Alloderm: New Evidence
Capsular contracture historically has been a very difficult problem for plastic surgeons to treat and manage both for cosmetic and reconstructive patients. Lately, there has been a resurgence in popularity of implant-based breast reconstruction as well as breast augmentation. With these procedures, there is a distinct, inherent risk of developing capsular contracture (i.e. hardening of the layer around the breast implant). When severe, capsular contracture can result in a hard, painful and sometimes distorted breast appearance.
With an increase in capsular contracture, has been an equally impressive resurgence in the use of acellular dermal matrices (i.e. Alloderm) in the treatment of capsular contracture. Plastic surgeons have been using Alloderm in cosmetic procedures for correcting a number of potential deformities, such as rippling or malposition of breast implants. In about 40-60% of patients who develop acute post-operative capsular contracture, use of asthma medications (i.e. Accolate) in an off-label fashion, has shown benefit in terms of improvement of severity of the contracture. Unfortunately, medications do not work for everyone and many patients require surgery. Recently, Cheng, Lakhiani and Saint-Cyr published their results on the treatment of capsular contracture utilizing complete implant coverage with Alloderm (PRS, Volume 132, No 3, September 2013, 9519.). Although this study looked at a small group of breast reconstruction patients (eleven patients/sixteen breasts), no patients experienced recurrent of their capsular contracture after a mean follow-up time of nine months.
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